Definition

Percentage of adults (18+, 18-25, 26+ years of age) with serious mental illness in the past year, defined as having reported a mental, behavioral, or emotional disorder that substantially interfered with or limited one or more major life activities on the [https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)].

Numerator

Weighted number of adults (18+, 18-25, 26+) who reported having a serious mental illness in the past year on the NSDUH.

Denominator

Weighted number of adults (18+, 18-25, 26+) with complete and valid responses on the NSDUH to the question on having a serious mental illness in the past year.

Data Interpretation Issues

The [https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)] is a nationally standardized survey that has been performed since 1971. The NSDUH is completed annually using a sample from the U.S. civilian, non-institutionalized population aged 12 or older. In 1999, the sample design expanded to include all 50 states and the District of Columbia. In 2002, the name of the survey was changed from the National Household Survey on Drug Abuse (NHSDA) to the NSDUH. Information on background and methodology of the NSDUH, managed by the Substance Abuse and Mental Health Services Administration (SAMHSA), can be found at [https://nsduhweb.rti.org/respweb/project_description.html].^1^
Recent data are predominantly from the 2-year averages of NSDUH surveys from Population Data - NSDUH at: [https://www.samhsa.gov/data/population-data-nsduh/reports?tab=33]. Historic data with maps and data downloads are available from the small area estimates website for state and national NSDUH surveys at: [http://pdas.samhsa.gov/saes/state].^1^
[[br]][[br]]
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{{class .SmallerFont
1. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. [http://www.samhsa.gov/data/]. Accessed February 14, 2017.
}}

Why Is This Important?

Mental health disorders are among the leading conditions that cause disability in high-income countries, accounting for 35% of all disability benefits in the U.S., Canada, and much of Europe.^2^ They also place a significant burden on individuals, families, employers, and health care systems nationwide.^3,4^ The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that in 2014, 9.8 million adults aged 18 and older in the U.S. had a serious mental illness, of which 1.7 million were between the ages of 18 and 25.^2^ Additionally, in 2014, 15.7 million adults aged 18 and older reported having experienced a major depressive disorder in the past year, and 11.8 million reported an unmet need for mental health treatment or counseling.^5,6^ Mental health is also a substantial problem in Alaska, where 14.8% of adults 18 years of age and older reported they experienced frequent mental distress on the 2016 Behavioral Risk Factor Surveillance System survey.^7^ As a result, recognizing, treating, and preventing mental health disorders is necessary to ensure the continued health of all Alaskans and the state as a whole.
Suicide is an avoidable cause of mortality that is a tragedy for all involved - families, friends, neighbors, colleagues, and communities. In 2013, suicide was the 10th leading cause of death in the United States overall, with more than 41,000 deaths by suicide. Among people aged 15 to 24, suicide ranked even higher as the second leading cause of death.^8^
However, individuals who die from suicide represent a fraction of those who consider or attempt suicide. Research suggests that there are more attempted suicides than there are deaths from suicide. Out of every 31 adults who attempted suicide in the past 12 months in the United States, there was 1 death by suicide. In addition, people are likely to have thought about suicide before actually attempting suicide. Suicide is of particular concern for young adults because the percentage of adults having serious thoughts of suicide in 2014 was higher among young adults aged 18 to 25 than among adults aged 26 to 49 and adults aged 50 or older (7.5% vs. 4.0% and 2.7%, respectively).^8^
[[br]][[br]]
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{{class .SmallerFont
2. Harvey SB, Henderson M, Lelliott P, Hotopf M. Mental health and employment: Much work still to be done. The British Journal of Psychiatry 2009;194(3)201-203.
3. Friedmann MS, McDermut WH, Solomon DA, Ryan CE, et al. Family functioning and mental illness: A comparison of psychiatric and nonclinical families. Family Process 1997;36(4):357-367.
4. Hu TW. Perspectives: an international review of the national cost estimates of mental illness, 1990-2003. J Ment Health Policy Econ 2006;9(1):3-13.
5. Substance Abuse and Mental Health Services Administration. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. [https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf]. Published September 2015. Accessed February 14, 2017.
6. Substance Abuse and Mental Health Services Administration. Receipt of services for behavioral health problems: Results from the 2014 National Survey on Drug Use and Health. [https://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.pdf]. Published September 2015. Accessed February 14, 2017.
7. Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS). Frequent mental distress. [http://ibis.dhss.alaska.gov/indicator/view/FMD.html]. Accessed May 23, 2017.
8. Lipari RN, Hughes A, Williams M. State estimates of past year serious thoughts of suicide among young adults: 2013 and 2014. [https://www.samhsa.gov/data/sites/default/files/report_2387/ShortReport-2387.html]. Published June 16, 2016. Accessed May 23, 2017.
}}

Healthy People Objective: Reduce the proportion of persons who experience major depressive episode (MDE)

U.S. Target: Not applicable, see subobjectives in this category

How Are We Doing?

The percentage of adults (18+ years of age) who reported having a serious mental illness in the past year ranged from 3.5% in 2008-2009 to 4.3% in 2012-2013. The increase in the percentages across these years was not significant, and there was no significant difference among the three age groups (18+, 18-25, and 26+ years of age) in the percentage of adults with serious mental illness.
The percentage of adults (18+ years of age) who reported having any mental illness in the past year ranged from 16.7% in 2008-2009 to 18.6% in 2012-2013, approximately five times the percentage of adults who reported serious mental illness. The percentage of adults reporting any mental illness did not differ significantly across 2008-2013 or among the three age grouping.
Significantly more adults between the ages of 18 and 25 reported having serious thoughts of suicide in the previous year than adults aged 18 and older or adults aged 26 and older (7.7% of 18-25 year olds in 2012-2013, compared to 4.2% of adults over 18 years old and 3.6% of adults over 26 years old). Additionally, the percentage of adults 18-25 who reporting having at least one major depressive episode in the past year increased significantly from 7.7% in 2005-2006 to 10.3% in 2012-2013, which was not observed in the other age groupings.

How Do We Compare With the U.S.?

The percentage of adults over 18 years of age in Alaska who reported having a serious mental illness in the past year was not significantly different from the U.S. during 2008-2013, nor was there a significant difference between Alaska and the U.S. in the percentage of adults (18+ years of age) reporting any mental illness. Alaska did not differ significantly from the U.S. in the percentage of adults (18+ years of age) who reported serious thoughts of suicide in the past year. There was also no significant difference between Alaska and the U.S. in the percentage of adults (18+ years of age) who reported at least one major depressive episode in the past year.
In 2015, there were an estimated 9.8 million adults aged 18 or older in the United States with serious mental illness (SMI)within the past year. This number represented 4.0% of all U.S. adults.^9^ In 2015, there were an estimated 43.4 million adults aged 18 or older in the United States with any mental illness (AMI) within the past year. This number represented 17.9% of all U.S. adults.^10^
The combined 2013-2014 NSDUH data indicate that an estimated 2.6 million young adults aged 18 to 25 in the United States had serious thoughts of suicide in the past year. This translates to about 1 in 13 young adults (7.4% of the population) having suicidal thoughts in the past year. Alaska fell within the highest quintile for serious thoughts of suicide among young adults with a prevalence of 8.30%.^8^
In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year. This number represented 6.7% of all U.S. adults.^11^
[[br]][[br]]
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{{class .SmallerFont
8. Lipari RN, Hughes A, Williams M. State estimates of past year serious thoughts of suicide among young adults: 2013 and 2014. [https://www.samhsa.gov/data/sites/default/files/report_2387/ShortReport-2387.html]. Published June 16, 2016. Accessed May 23, 2017.
9. National Institute of Mental Health. Serious mental illness (SMI) among U.S. adults. [https://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml]. Accessed May 23, 2017.
10. National Institute of Mental Health. Any mental illness (AMI) among U.S. adults. [https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml]. Accessed May 23, 2017.
11. National Institute of Mental Health. Major depression among adults. [https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml]. Accessed May 23, 2017.
}}

Evidence-based Practices

SAMHSA maintains a website that collects the latest in mental health prevention evidence based practices. The link can be found here: [https://www.samhsa.gov/ebp-web-guide/prevention-mental-health-disorders]. The site also collects evidence based practices for the treatment of mental health disorders, which can be found here: [https://www.samhsa.gov/ebp-web-guide/mental-health-treatment].

Available Services

Resources for crisis intervention, locating mental health treatment facilities near you, and other supports can be found at the bottom of the Division of Behavioral Health website under "Self Help Resources": http://dhss.alaska.gov/dbh/Pages/default.aspx
The Alaska Mental Health Board also provides resources for mental health, which can be found here: http://dhss.alaska.gov/amhb/Pages/resource.aspx

Data Notes

The data presented here are from the [https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], which defines Serious Mental Illness (SMI) as:
* A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders);[[br]]
* Diagnosable currently or within the past year;[[br]]
* Of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and,[[br]]
* Resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.^5^[[br]][[br]]
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{{class .SmallerFont
5. NIMH - Serious Mental Illness (SMI) Among U.S. Adults. [https://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml] Accessed May 23, 2017.
}}

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

The data presented here are from the [https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], which defines Serious Mental Illness (SMI) as:
* A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders);[[br]]
* Diagnosable currently or within the past year;[[br]]
* Of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and,[[br]]
* Resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.^5^[[br]][[br]]
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{{class .SmallerFont
5. NIMH - Serious Mental Illness (SMI) Among U.S. Adults. [https://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml] Accessed May 23, 2017.
}}

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

The data presented here are from the [https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], which defines Serious Mental Illness (SMI) as:
* A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders);[[br]]
* Diagnosable currently or within the past year;[[br]]
* Of sufficient duration to meet diagnostic criteria specified within the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); and,[[br]]
* Resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.^5^[[br]][[br]]
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{{class .SmallerFont
5. NIMH - Serious Mental Illness (SMI) Among U.S. Adults. [https://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml] Accessed May 23, 2017.
}}

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having any mental illness (i.e., any mental, behavioral, or emotional disorder that meets DSM-IV criteria [excluding developmental disorders and substance use disorders]) in the past year [[br]]
Numerator: Weighted number of adults (18+) who reported having any mental illness in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having any mental illness in the past year.^6^[[br]][[br]]
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{{class .SmallerFont
6. NIMH - Any Mental Illness (AMI) Among U.S. Adults. [https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml] Accessed May 23, 2017.
}}

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having any mental illness (i.e., any mental, behavioral, or emotional disorder that meets DSM-IV criteria [excluding developmental disorders and substance use disorders]) in the past year [[br]]
Numerator: Weighted number of adults (18+) who reported having any mental illness in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having any mental illness in the past year.^6^[[br]][[br]]
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{{class .SmallerFont
6. NIMH - Any Mental Illness (AMI) Among U.S. Adults. [https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml] Accessed May 23, 2017.
}}

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having any mental illness (i.e., any mental, behavioral, or emotional disorder that meets DSM-IV criteria [excluding developmental disorders and substance use disorders]) in the past year [[br]]
Numerator: Weighted number of adults (18+) who reported having any mental illness in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having any mental illness in the past year.^6^[[br]][[br]]
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{{class .SmallerFont
6. NIMH - Any Mental Illness (AMI) Among U.S. Adults. [https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml] Accessed May 23, 2017.
}}

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having experienced serious thoughts of suicide in the past year [[br]]
Numerator: Weighted number of adults (18+) who reported having experienced serious thoughts of suicide in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having experienced serious thoughts of suicide in the past year.

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having experienced serious thoughts of suicide in the past year [[br]]
Numerator: Weighted number of adults (18+) who reported having experienced serious thoughts of suicide in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having experienced serious thoughts of suicide in the past year.

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having experienced serious thoughts of suicide in the past year [[br]]
Numerator: Weighted number of adults (18+) who reported having experienced serious thoughts of suicide in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having experienced serious thoughts of suicide in the past year.

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Mental Illness - Had at Least One Major Depressive Episode in the Past Year - Adults (18+), Alaska and U.S., 2005-2006 to 2012-2013 (2-year average)

Alaska Comparisons

Percentage of adults (18+)

Lower Limit

Upper Limit

Record Count: 16

All Alaskans

2005-2006

6.1%

5.0%

7.4%

All Alaskans

2006-2007

6.9%

5.6%

8.4%

All Alaskans

2007-2008

6.3%

5.1%

7.8%

All Alaskans

2008-2009

5.9%

4.7%

7.3%

All Alaskans

2009-2010

6.7%

5.6%

8.1%

All Alaskans

2010-2011

6.9%

5.6%

8.4%

All Alaskans

2011-2012

7.0%

5.8%

8.5%

All Alaskans

2012-2013

7.3%

6.0%

8.8%

U.S.

2005-2006

6.5%

6.3%

6.8%

U.S.

2006-2007

6.6%

6.4%

6.9%

U.S.

2007-2008

6.6%

6.4%

6.9%

U.S.

2008-2009

6.5%

6.3%

6.8%

U.S.

2009-2010

6.7%

6.5%

7.0%

U.S.

2010-2011

6.7%

6.4%

7.0%

U.S.

2011-2012

6.7%

6.5%

7.0%

U.S.

2012-2013

6.8%

6.5%

7.0%

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having at least one major depressive episode (MDE) in the past year. MDE is defined using the diagnostic criteria from the DSM-IV. Adults were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth[[br]]
Numerator: Weighted number of adults (18+) who reported having at least one MDE in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having at least one MDE in the past year
Unlike the definition in the DSM-IV, no exclusions were made for a major depressive episode caused by medical illness, bereavement, or substance use disorders.^7^[[br]][[br]]
----
See '''Resources and References'''

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Mental Illness - Had at Least One Major Depressive Episode in the Past Year - Adults (18-25), Alaska and U.S., 2005-2006 to 2012-2013 (2-year average)

Alaska Comparisons

Percentage of adults (18-25)

Lower Limit

Upper Limit

Record Count: 16

All Alaskans

2005-2006

7.7%

6.3%

9.4%

All Alaskans

2006-2007

8.5%

6.9%

10.4%

All Alaskans

2007-2008

7.8%

6.3%

9.7%

All Alaskans

2008-2009

7.3%

5.8%

9.2%

All Alaskans

2009-2010

8.1%

6.6%

9.9%

All Alaskans

2010-2011

9.1%

7.4%

11.0%

All Alaskans

2011-2012

10.9%

9.0%

13.1%

All Alaskans

2012-2013

10.3%

8.5%

12.4%

U.S.

2005-2006

8.4%

8.1%

8.8%

U.S.

2006-2007

8.1%

7.7%

8.4%

U.S.

2007-2008

8.2%

7.9%

8.5%

U.S.

2008-2009

8.2%

7.9%

8.6%

U.S.

2009-2010

8.2%

7.8%

8.5%

U.S.

2010-2011

8.3%

8.0%

8.6%

U.S.

2011-2012

8.6%

8.2%

9.0%

U.S.

2012-2013

8.8%

8.5%

9.2%

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having at least one major depressive episode (MDE) in the past year. MDE is defined using the diagnostic criteria from the DSM-IV. Adults were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth[[br]]
Numerator: Weighted number of adults (18+) who reported having at least one MDE in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having at least one MDE in the past year
Unlike the definition in the DSM-IV, no exclusions were made for a major depressive episode caused by medical illness, bereavement, or substance use disorders.^7^[[br]][[br]]
----
See '''Resources and References'''

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

Mental Illness - Had at Least One Major Depressive Episode in the Past Year - Adults (26+), Alaska and U.S., 2005-2006 to 2012-2013 (2-year average)

Alaska Comparisons

Percentage of adults (26+)

Lower Limit

Upper Limit

Record Count: 16

All Alaskans

2005-2006

5.8%

4.6%

7.2%

All Alaskans

2006-2007

6.6%

5.2%

8.3%

All Alaskans

2007-2008

6.0%

4.7%

7.6%

All Alaskans

2008-2009

5.6%

4.3%

7.2%

All Alaskans

2009-2010

6.5%

5.2%

8.1%

All Alaskans

2010-2011

6.4%

5.0%

8.2%

All Alaskans

2011-2012

6.3%

4.9%

8.0%

All Alaskans

2012-2013

6.7%

5.3%

8.5%

U.S.

2005-2006

6.2%

5.9%

6.5%

U.S.

2006-2007

6.4%

6.1%

6.7%

U.S.

2007-2008

6.3%

6.0%

6.6%

U.S.

2008-2009

6.2%

6.0%

6.5%

U.S.

2009-2010

6.5%

6.2%

6.8%

U.S.

2010-2011

6.4%

6.1%

6.7%

U.S.

2011-2012

6.4%

6.1%

6.7%

U.S.

2012-2013

6.4%

6.1%

6.7%

Data Notes

Definition: Percentage of adults (18+ years of age) who reported having at least one major depressive episode (MDE) in the past year. MDE is defined using the diagnostic criteria from the DSM-IV. Adults were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth[[br]]
Numerator: Weighted number of adults (18+) who reported having at least one MDE in the past year[[br]]
Denominator: Weighted number of adults (18+) with complete and valid responses on the NSDUH to the question of having at least one MDE in the past year
Unlike the definition in the DSM-IV, no exclusions were made for a major depressive episode caused by medical illness, bereavement, or substance use disorders.^7^[[br]][[br]]
----
See '''Resources and References'''

Data Source

[https://www.samhsa.gov/data/population-data-nsduh National Survey on Drug Use and Health (NSDUH)], Substance Abuse and Mental Health Administration, U.S. Department of Health and Human Services.

References and Community Resources

'''References: '''
1. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. [http://www.samhsa.gov/data/]. Accessed February 14, 2017.
2. Harvey SB, Henderson M, Lelliott P, Hotopf M. Mental health and employment: Much work still to be done. The British Journal of Psychiatry 2009;194(3)201-203.
3. Friedmann MS, McDermut WH, Solomon DA, Ryan CE, et al. Family functioning and mental illness: A comparison of psychiatric and nonclinical families. Family Process 1997;36(4):357-367.
4. Hu TW. Perspectives: an international review of the national cost estimates of mental illness, 1990-2003. J Ment Health Policy Econ 2006;9(1):3-13.
5. Substance Abuse and Mental Health Services Administration. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. [https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf]. Published September 2015. Accessed February 14, 2017.
6. Substance Abuse and Mental Health Services Administration. Receipt of services for behavioral health problems: Results from the 2014 National Survey on Drug Use and Health. [https://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014/NSDUH-DR-FRR3-2014.pdf]. Published September 2015. Accessed February 14, 2017.
7. Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS). Frequent mental distress. [http://ibis.dhss.alaska.gov/indicator/view/FMD.html]. Accessed May 23, 2017.
8. Lipari RN, Hughes A, Williams M. State estimates of past year serious thoughts of suicide among young adults: 2013 and 2014. [https://www.samhsa.gov/data/sites/default/files/report_2387/ShortReport-2387.html]. Published June 16, 2016. Accessed May 23, 2017.
9. National Institute of Mental Health. Serious mental illness (SMI) among U.S. adults. [https://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml]. Accessed May 23, 2017.
10. National Institute of Mental Health. Any mental illness (AMI) among U.S. adults. [https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml]. Accessed May 23, 2017.
11. National Institute of Mental Health. Major depression among adults. [https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml]. Accessed May 23, 2017.
12. State of Alaska, Division of Behavioral Health. Welcome to behavioral health. [http://dhss.alaska.gov/dbh/Pages/default.aspx]. Accessed May 18, 2017.
'''Resources:'''
NSDUH State Estimates. [http://pdas.samhsa.gov/saes/state]
Population Data / NSDUH | SAMHSA. [https://www.samhsa.gov/data/population-data-nsduh]

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